Until the Irish government repeals the Eighth Amendment and replaces the new unworkable law with policies that facilitate rather than obstruct access to abortion, women will continue to be seen simply as means to an end.

“I am not a vessel” has become a popular mantra for Irish reproductive rights advocates after Sir Nigel Rodley, chair of the UN Human Rights Committee, chastised Irish law for treating women who are raped and subsequently denied abortion and forced to carry a pregnancy to term as “a vessel and nothing more.” But in a country where an embryo has the same constitutional rights as a woman, we know that women are considered mere vessels, and never has this been more vividly demonstrated than in last week’s revelations about the forced pregnancy, forced hydration, and coerced cesarean section of a survivor of rape who was seeking asylum in Ireland.

Following the enormous public outcry after the preventable death of Savita Halappanavar, who was denied a life-saving abortion, the Irish government was put under huge pressure to address the lack of clarity in the law about when and why an abortion could be legally provided. However, the day they changed the name of the draft legislation from the “Protection of Maternal Life Act” to the “Protection of Life in Pregnancy Act,” I predicted that nothing would change. It was clear that the Eighth Amendment—which “acknowledges the right to life of the unborn and, with due regard to the equal right to life of the mother”—would prevail.

Even if you could believe, in principle, that a fetus or even a zygote should have the same value and the same legal protections as a woman, it is clear that in practice the rights of a woman and her fetus will sometimes be in competition—when a woman’s life is threatened by the continuation of her pregnancy, as it was for Halappanavar; when urgent and vital medical treatment for the woman carries risks for the embryo; or when the pregnancy is causing suicidal intent. In these situations, the state or the medical profession has no choice but to come down on one side or the other. We have to ask why, time after time in Ireland, the fetus’ rights have trumped those of the woman?

Facts are still emerging in the most recent case reported in Ireland. It seems that a woman, pregnant as a result of rape, sought an abortion at eight weeks of pregnancy. She was denied an abortion, despite meeting the legal criteria (two psychiatrists confirmed that she was suicidal and therefore theoretically eligible under the new act). Perhaps because of her immigration status, she was unable to do what so many Irish women do, which is to beg and borrow to fly to England or the Netherlands for a privately funded abortion. Lied to and obstructed, when she finally realized she would not be permitted an abortion she went on hunger strike, refusing food and water. Doctors were awarded a court order to forcibly hydrate her. Subsequently they sought a court order to force her to have a live delivery by cesarean section against her will. Finally—clearly under duress—she agreed to the procedure. The whole process was aimed at delivering a baby—albeit so prematurely that the baby bears the risk of living with serious developmental and physical disabilities.

I once debated with an anti-choice campaigner who declared that one day society will have the technology to keep a “baby” alive outside of a woman’s womb after a couple of months. No woman, he asserted, would begrudge continuing the unwanted pregnancy for just a few weeks until their fetus could safely complete its gestational development in a machine and then be adopted by a deserving childless couple—could they? Of course we know they could. Moreover, 15 years later no such technology exists. In fact, neonatologists think that at 24 weeks, regardless of technological advances, we have pretty much reached the limits of viability determined by the physiological development of a fetus and can only hope to improve outcomes for babies born at or after that point.

However, for fundamentalist anti-choice campaigners these facts present no obstacle—after all, we have women to carry children to term, whether they like it or not, even when doing so threatens their health and lives. On Monday, August 18, on BBC Radio Ulster, anti-choice guest David Quinn lamented that the woman at the center of last week’s controversy had her cesarean section at 24 weeks and was not forced to continue the pregnancy until she could deliver a healthy, fully developed baby at 40 weeks: “A truly ‘pro-life’ culture would have looked after the mother until longer into her pregnancy, so as to ensure that the baby was going to be a healthy baby when delivered.”

This is the logic of the anti-choice movement and the Irish legal and medical profession that saw this young woman only as a walking incubator, rather than a human being of flesh, blood, and feelings. International law, policy, and convention and common sense tell us that women are not simply wombs to be commandeered in the service of childbearing. Until the Irish government repeals the Eighth Amendment and replaces the new unworkable law with policies that facilitate rather than obstruct access to abortion, women will continue to be seen simply as means to an end: vessels.

Abortion, while legal under extremely restrictive circumstances in both parts of Ireland—like if you can prove that birthing a baby will actively kill you—is virtually impossible to obtain in these countries.

On June 12, the UK Department of Health published its report on abortion statistics for 2013. The numbers show that the abortion rate fell slightly in 2013, to 15.9 per 1,000 women, the lowest rate in 16 years. A great analysis of the report was done by the British Pregnancy Advisory Service and can be found here. (As an American ex-pat, I’d also like to take a moment to gloat over the fact that in England, Scotland, and Wales abortion is free on the National Health Service. No, that wasn’t a typo. FREE.)

The statistics also cover a group of women for whom abortions are not free: women who travel from Northern Ireland and the Republic of Ireland to England to access a safe, legal abortion. Abortion, while legal under extremely restrictive circumstances in both parts of Ireland—like if you can prove that birthing a baby will actively kill you—is virtually impossible to obtain in these countries. This means that, when faced with an unplanned or unwanted pregnancy in Ireland, women with money have options, and women without money have babies—or, in some cases, do dangerous and desperate things.

The numbers show a reduction in the number of women from Ireland and Northern Ireland traveling to England to access a safe and legal abortion—4,481, down from 4,887—the lowest reported number since 1969. While some organizations and groups in Ireland and Northern Ireland will undoubtedly greet the news of a reduction in numbers with positive fanfare, these numbers only tell part of the story. They do not include the women who come to England and give the address of a local friend or family member, the women who travel to other countries to access abortions, or the hundreds, if not thousands, of women who obtain early medical abortion pills online from Women on Web. These numbers also do not capture the women who cannot travel—women who need but can’t get passports or visas to travel, women who can’t escape from violent partners, women who don’t have anyone who can watch their children while they travel, and women who do not have the £400 to £2,000 ($675 to $3,350) it costs to travel to England and pay privately for an abortion. If these women cannot access Women on Web, they are forced to choose between continuing the pregnancy anyway, or attempting to self-abort in much more dangerous ways.

While the Department of Health is reporting a year on year decline in the numbers of women traveling, another group is reporting an increase. Abortion Support Network (ASN) is a grassroots charity that provides financial assistance, practical information on how to organize the least expensive abortion, and accommodation in volunteer homes for women traveling from Ireland to England. We have experienced a steep increase in calls from women in Ireland and Northern Ireland. In 2013, ASN was contacted by 446 women and couples seeking support in order to access a safe and legal abortion; this is up from 363 in 2012 and 253 in 2011. We have heard from more than 250 in the first six months of 2014. Every day, ASN receives calls, texts, and emails from women and couples in Ireland and Northern Ireland. In addition to deciding whether or not to terminate a pregnancy, these women must also find the money to pay for the procedure, which can range from £330 to £1,350 ($550 to $2,250) depending on the stage of pregnancy, plus a mandatory consultation fee, not to mention a bus to the airport, plane tickets, a passport, child care, and other costs. This cost is an especially heavy cross to bear for women in Northern Ireland. Though they are also taxpaying citizens of the United Kingdom, they are denied abortion care on the National Health Service.

The continued increase in women contacting ASN is further proof that criminalizing abortion does not end abortion—it simply makes it more difficult for poor women and families to access. (Do you hear that, Texas and Louisiana state legislators?) The sustained economic slump is making it even more of a struggle for women and families to keep their heads above water and Ireland’s severe abortion restrictions make it even harder for this group.

These are some examples of the women and families who have contacted ASN:

“My partner and I found out that the baby we’re expecting is incompatible with life, the baby has a rare abnormality and will not survive outside the womb and because of backward Irish law we don’t know where to turn.”

“I’m a mother of 3 and am in absolute shock that I am pregnant – I never wanted any more kids. My relationship is not stable enough to be having a new baby and financially I can’t afford it. I was totally against abortion but it is the only thing that I want to do. I am trying to get the money together to go if there is any help at all it would be appreciated or even if you know the best clinics or the cheapest ones.”

“Please help. I’ve tried everything to try to miscarry. I’ve been drinking excessively. I’ve tried throwing myself downstairs, and even tried to overdose. I can’t have this child. I don’t want it! I’m completely on my own. No one else knows and I’m at the end of my tether, I feel like I’m going to have a breakdown.”

“I’m a student and I’m approximately 18 weeks pregnant. I can’t financially and emotionally support a child so I’m planning on having an abortion. The problem is my partner and I have both been saving and scraping money together but we’re still short. I was enquiring as to whether we could get any assistance, be it monetary or just providing us with somewhere to stay when we get there.”

And this is just the tip of the iceberg. Since opening in October 2009, ASN has heard from more than 1,400 women, couples, and families forced by Ireland’s draconian abortion laws to call a complete stranger in another country to ask for money to help pay for their abortions. Some of these women, before finding out about ASN, have taken dangerous and desperate action to try and get money together or, worse, to self-abort. Women have sold the family car, chased packets of birth control pills with bottles of vodka, rationed food for their kids, skipped meals, borrowed money from unscrupulous money lenders, returned Christmas presents, and drunk bleach trying to procure an abortion. Because no matter what the “pro-life” lobby says, there is no world where all women who become pregnant carry those pregnancies to term and everyone lives happily ever after. Women who do not want to be pregnant will try literally anything not to be pregnant.

Other than ending patriarchy and changing the beliefs of people who can’t seem to grasp that choosing not to have a child at a particular point in your life, or ever, is in itself a valid, moral decision that is, to put it bluntly, not their business, there are interim solutions. Ireland’s Abortion Rights Campaign and Northern Ireland’s Alliance for Choice are fighting tooth and nail for law reform, while groups like Speaking of I.M.E.L.D.A (Ireland Making England the Legal Destination for Abortion) and Dublin Nights for Choice take less traditional approaches to raising public awareness and helping women access abortions.

The UK Department of Health numbers are not the full truth, but the people and groups working directly with women and families in Ireland know that when it comes to abortion, the statistics seldom tell the real story.

In a scathing report released Wednesday on the Holy See’s adherence to the principles of the Convention on the Rights of the Child, an aggressive United Nations committee knocked the Holy See off the high ground.

Stunning in its frankness and scope, the report began with the unequivocal rejection of the Holy See’s specious claim that while the Vatican City has a hallowed place in the international community (for example, as a non-member permanent observer at the UN), it is utterly impotent over the workings of the millions of institutions worldwide operating in the Catholic Church’s name.

Recognizing that subordinates of Catholic religious orders are, by canon law, “bound by obedience to the Pope,” the committee rejected the Holy See’s claim of impotence. By ratifying the convention, the committee contended, the Holy See committed itself to implementing the convention “not only on the territory of the Vatican City State but also as the supreme power of the Catholic Church through individuals and institutions placed under its authority.”

The report left no doubt about the committee’s lack of faith in the Holy See’s efforts so far to come to terms with the decades-long epidemic of child sex abuse by Catholic clerics worldwide. “The Holy See has not acknowledged the extent of the crimes committed, has not taken the necessary measures to address cases of child sexual abuse and to protect children, and has adopted policies and practices which have led to the continuation of the abuse by and the impunity of the perpetrators,” wrote the committee.

Its recommendations were unequivocal: immediate removal of all known and suspected child sexual abusers; referral of cases to law enforcement; sharing archives that can be used to hold abusers, enablers, and concealers accountable; amending canon law to make child sexual abuse an actual crime; establishing rules for mandatory reporting; providing justice, healing, and compensation to victims; and fighting to extend statutes of limitations on child sex abuse instead of lobbying against them.

But the UN panel did not stop there. It refused to cede the moral high ground, to stop at the doctrinal door. It unflinchingly called the Holy See to account not only for failing to protect the rights of children sexually abused by priests, but for egregiously failing to recognize, much less protect, the health and rights of girls. One by one, it tackled issues in the context of global justice, not religious teachings.

Taking another skeleton out of the clerical closet, the committee advocated that the Holy See “assess the number of children born of Catholic priests, find out who they are and take all the necessary measures to ensure the rights of these children to know and to be cared for by their fathers, as appropriate.” The committee also argued for putting an end to the despicable bargain many mothers seeking child support had to strike with the church—signing a confidentiality agreement in exchange for financial help.

The committee expressed “deepest concern” over the church’s treatment of a 9-year-old girl in Brazil who was raped by her step-father and then had a life-saving abortion. Her abortion brought on the excommunication of her mother and the doctor who performed the procedure, a sanction, the committee noted, “later approved by the head of the Roman Catholic Church’s Congregation of Bishops.”

Recognizing the enormous risks to women’s health and lives worldwide as a result of the church’s Ethical and Religious Directives for its health-care facilities, which forbid direct abortion under any conditions at all, the committee urged the Holy See “to review its position on abortion and … amend Canon 1398 relating to abortion with a view to identifying circumstances under which access to abortion services can be permitted.”

The committee zeroed in on “the negative consequences of the Holy See’s position and practices of denying adolescents access to contraception, as well as to sexual and reproductive health and information.” Among those consequences they listed are early and unwanted pregnancies, high morbidity and mortality for adolescent girls from clandestine abortions, and increased risk of sexually transmitted diseases (STDs) and HIV and AIDS.

In a tone rarely if ever directed at members of the Catholic hierarchy in polite conversation, the committee made a host of eye-popping recommendations. It advised the Holy See to overcome “barriers and taboos” surrounding adolescent sexuality that impede access to sexual and reproductive health information, contraceptives, and means to prevent HIV and STDs; guarantee consideration of the “best interest of pregnant teenagers”; and, most boldly, ensure that adolescent “sexual and reproductive health education be part of the mandatory curriculum of Catholic schools … with special attention to preventing early pregnancy and sexually transmitted infections.”

Relentlessly pressing on, the committee advocated for accountability, justice, and redress for the young girls who suffered “inhuman, cruel and degrading treatment as well as physical and sexual abuse” in the notorious Catholic-run Magdalene Laundries in Ireland and similar institutions in other locations. It raised the issue of “the devastating impact of domestic violence on children,” violence that “often has a gender component.” While commending the Holy See for committing “to promoting the dignity of women and girls,” it chastised them for failing, at the 2013 Commission on the Status of Women, to support a document proposing that “religion, custom or tradition should not serve as an excuse for states to evade their obligations to protect women and girls from violence.”

The report represents a shocking rebuke of the Catholic hierarchy’s internal machinations and its application of its doctrinal system to a secular world. Not surprisingly, it almost instantly engendered an outcry of “anti-Catholic” accusations. In its terse reply issued right after the report came out, the Holy See voiced “regret to see in some points of the Concluding Observations an attempt to interfere with Catholic Church teaching on the dignity of the human person and in the exercise of religious freedom.” Furthermore, it said, “the Holy See reiterates its commitment to defending and protecting the rights of the child, in line with the principles promoted by the Convention on the Rights of the Child and according to the moral and religious values offered by Catholic doctrine.”

And therein lies the rub. This is an institution that has succeeded for centuries in straddling the line between secular and spiritual. Today, it regularly shifts sides to suit its purposes—to the secular side, claiming its seat at the UN, when it wants to exercise power on the world stage; to the spiritual side, claiming religious freedom, when it doesn’t want to abide by the world’s civil laws, criminal laws, or international norms.

In a sense, with this report, the UN Committee on the Rights of Children threw down a gauntlet. It has called the Catholic Church on its dual identity and asked it to choose. Some will think that’s unfair. I don’t. Any church can hold any beliefs it chooses, preach those beliefs to its followers, while remaining subject to civil and criminal laws. But no church should be able to hold itself out as also being a sovereign state that is above the law, with the divine right to impose its doctrines and dogmas on everyone.

The Oscar-nominated film Philomena tells the tale of an Irish Catholic mother separated from her son by one of Ireland's infamous 20th century Magdalene Laundries. But this adoption system wasn't limited to mid-century Ireland; there are millions of Philomenas out there.

“We all knew what it meant when a big car arrived,” says Philomena Lee, the namesake character of the Oscar-nominated film Philomena (starring Judi Dench), which tells the tale of an Irish Catholic mother separated from her son by one of Ireland’s infamous 20th century Magdalene Laundries. The laundries were convents-cum-reformatories where unwed pregnant women (or girls caught having sex, or girls who were raped, or girls just thought to be promiscuous), were sent to atone for their sins—usually through hard labor, washing laundry sent in from neighboring villages. They were also de facto adoption agencies, as Catholics from Ireland, but more often the United States, came to adopt the children delivered by pregnant Magdalenes.

What the big car meant, in Philomena’s case, was that an American doctor and his wife had come to adopt her son, Anthony. Like other children born in the convent, Anthony was labeled an orphan, abandoned by his mother, who, though she lived in close proximity to him in the convent, was only allowed to see him an hour a day. Like most other mothers in the laundry, Philomena had to watch as her son was delivered into strangers’ hands, while she remained to work in the convent to pay off her debt for being taken in: four years of labor in lieu of a £100 fee she couldn’t afford. Fifty years later, a modern generation of nuns, wearing friendly cardigans and pouring tea, offered Philomena sympathy, but no information on Anthony’s whereabouts, while residents of the local town whispered that the nuns burned documents to obscure how they’d “sold all those babies to America.”

This is the set-up that sends Philomena, along with world-weary journalist Martin Sixsmith, to America, to search out traces of her son. After they realize early on that he has died—a casualty of the AIDS crisis—the movie’s drama deals with how Philomena faces her grief, her worries that her son had forgotten or resented her, and her pained loyalty to the Catholic Church that oversaw their separation. Philomena, who in the movie and in real life remains a devout Catholic, ceaselessly defended the nuns who imprisoned her and the system they upheld, couching each tentative request for information with assurances that she doesn’t blame the church, and refusing that she was coerced. “I could have never given him a life like this,” she says, reflecting on the comparative opulence of her son’s upper-middle-class life in the United States.

At the end of the movie, Philomena encounters an unrepentant old-school nun who vehemently defends the adoptions—and her subsequent lies to both mother and son—as the just rewards for sex outside marriage. Martin becomes furious, but Philomena forgives, chastising the journalist for his “exhausting” anger.

Many would read this moral as a particularly Christian message. In any case, it’s one of forgiveness and acceptance. Although the abuses Philomena represented are far tamer than the sadistic cruelty depicted in the 2002 film The Magdalene Sisters,when Philomena was released late last fall, New York Post reviewer Kyle Smith nonetheless panned it as “another hateful and boring attack on Catholics.” Shifting into an anti-abortion argument in a second piece on the movie, written in response to filmmaker Harvey Weinstein’s rebuttal of the review, Smith sneered at the suggestion that the adoptions at the Magdalene Laundries were anything but altruistic. “We all know how cruel it was for the mid-century Catholic Church to provide shelter for scorned women written off as dead by their families, help them give birth to their children and place the adoptees in loving homes,” he wrote. In an open comment to the real Philomena Lee, Smith reminds her that, in the movie, her character avows that the choice to relinquish was hers.

If anything, far from being an anti-Catholic film, Philomena may stray too far in the direction of letting bygones be bygones, and in suggesting forgiveness for a system—both religious and societal—that penalized women who got caught having sex with one of the harshest penalties imaginable: losing their children. (In fact, the emphasis on forgiveness may be poetic license: In the nonfiction book the movie is based on, Martin Sixsmith’s The Lost Child of Philomena Lee, Sixsmith writes that when she learned about the nuns’ obstruction of her and her son’s efforts to connect, the real-life Philomena was angry.)

But a more significant failing of Smith’s review, and his sarcastic follow-up, is his apparently total blindness to the historical reality that Philomena is based on. Not only was the adoption system of the Magdalene Laundries far from benevolent, it was far from limited to mid-century Ireland. The fact is, there are millions of Philomenas.

The “Baby Scoop Era”

Between the 1940s and 1973, when abortion was illegal and single motherhood taboo, unmarried women who became pregnant faced few, punishing options: a shotgun wedding to the father, an illegal abortion that could result in maiming or death, a pariah’s life as a single parent, or “going away,” to one of hundreds of homes for unwed mothers for the duration of their pregnancy, to relinquish their babies for adoption and return home as though nothing had happened. Overwhelmingly, women chose—or were forced to choose—the latter.

It’s a time that in the United States is often referred to as the “Baby Scoop Era,” and during it some estimates hold that a full fifth of all children born to never-married white women relinquished their infants for adoption. For women sent to maternity homes, that number rose to 80 percent, comprising anywhere from 1.5 million to 6 million women.

While, at least in the movie, Philomena maintained that she was never coerced into relinquishing her son, for many U.S. birth mothers or first mothers (preferred terms vary) who are now in their 50s, 60s, or older, the pressure they encountered at maternity homes was harsh and unapologetic. Severe isolation was normal, as was withholding information from women about their pregnancies and impending labor. Maternity home residents were forbidden visits with friends, family, or the fathers of their children, and weren’t allowed to receive letters or phone calls. They were sometimes dropped off at hospitals to labor alone, separate from married mothers, sometimes without pain medication, and pushed to sign relinquishment papers while they were still drugged or recovering from labor. Many were told to deny that they knew the fathers of their children, deliberately misled about their right to keep their babies or about services that could help them, and frequently refused a chance to hold their children after birth. Some had their babies taken while they were sedated or were told that the babies had been stillborn, but were never shown their bodies.

“They wanted to keep us scared to death,” said Karen Wilson-Buterbaugh, the 65-year-old founder of the Baby Scoop Era Research Initiative, which compiles documents from the period. “They didn’t want us to be repeats. It was so traumatizing that many mothers don’t remember the births.”

As a 17-year-old unwed expectant mother, Wilson-Buterbaugh was placed by her Catholic family in a Washington, D.C.-area maternity home in 1966. Women sent there were expected to work for their keep, and there were locks on the doors of the floors housing women considered flight risks. To Wilson-Buterbaugh, the differences between the U.S. maternity homes and the Magdalene Laundries are few. In the United States, widely available baby formula allowed infants to be adopted almost immediately, rather than staying with breastfeeding mothers, and U.S. women were sent home quickly, to return to their lives as “born-again virgins,” unlike their Irish counterparts, who were penalized with further years of debt-bondage. But for many, the sense of lifelong loss is the same.

Lee Campbell, the founder, in 1976, of the pioneering organization Concerned United Birthparents (CUB), the first support group for mothers and fathers whose children were adopted, emphasized how catastrophic that loss could be. Many mothers who relinquished children suffered symptoms of post-traumatic stress disorder (PTSD), and some even experienced grief that researchers found to be more intense than the pain of women whose children died—their pain compounded by a paralyzing lack of resolution, as they wondered for years what happened to their child. Some mothers say the grief was so overwhelming that they couldn’t bring themselves to recognize their loss until years or decades later.

“Birthmothers were like members of a 1978 religious sect in Jonestown who followed their leaders’ command to drink Kool-Aid that had been laced with cyanide,” writes Campbell, in a CUB review of Philomena. “I admit that for ten years, I obediently drank from my own PTSD chalice of Kool-Aid. When its potency began to wane and my PTSD erupted in full, as textbooks say it will after eight to ten years, I started CUB.”

The problems didn’t stop with the end of the Baby Scoop Era in 1973, though the tactics became, in some ways, subtler. For my 2013 book The Child Catchers: Rescue, Trafficking, and the New Gospel of Adoption, I interviewed other mothers who relinquished children for adoption in the mid-80s in Catholic maternity homes, where they were threatened with lawsuits if they backed out of planned adoptions. I interviewed more mothers who’d relinquished in the 2000s, after being sent to modern evangelical maternity homes that coached young Christians to believe that relinquishing would bring God’s blessing.

The problems didn’t stop at U.S. borders either. Similar adoption programs occurred in other countries, particularly Commonwealth nations. However, some of these nations have begun to acknowledge their mistakes. In Canada, several churches have undertaken archival digs to determine what role they may have played in coercive adoptions. In Australia, the advocacy of Baby Scoop Era mothers resulted last year in a national apology from the prime minister for forced adoptions, modeled on the country’s previous apologies for human rights abuses—including forcible adoptions—of indigenous people.

The American Philomenas

For the New York Post’s Kyle Smith, this is apparently unknown history, papered over with the assumption that more adoptions are good, and therefore maternity homes that facilitate more adoptions are good. That’s not a big surprise, but even likely allies seem unaware of the connections between Philomena’s quest and the experiences of millions of U.S. women. Last week, Sen. Claire McCaskill (D-MO) partnered with the real Philomena Lee to call on Ireland to open its adoption records and grapple with its past (a call reflected in a recent Change.org petition aimed at the Catholic Church). U.S. birth mothers/first mothers have started a Facebook group called “We Are the American Philomenas,” and they share a sense of bafflement that most people are unaware of how common their story is.

“It’s just beyond our comprehension that they can’t connect those dots, especially after all the efforts we’ve made,” Wilson-Buterbaugh says. “There are millions of Philomenas out there, from just about every country. We’re just flabbergasted that people aren’t figuring this out.”

Like a number of Baby Scoop Era mothers I spoke to, Wilson-Buterbaugh worries that their stories may die with them. CUB’s Lee Campbell worries that, with fading media interest in their stories and a lack of outside support, “CUB’s growl has faded to a mew,” while problems in domestic adoption persist.

This fall, I sat in a room full of mothers at CUB’s annual retreat—women who had relinquished children for adoption ten, 20, or 40 years before. It was a room moved easily to tears, as panel after panel included personal testimonies from women who, decades later, were still hoping to reconnect with their now-adult children, or who had found their children and reunited, only to have them later pull away, overwhelmed by the weight of emotion. No matter how many years they were removed from that loss, the women I met still mourned. And many were still angry.

Representing that anger might have perhaps made Philomena a less palatable film for many mainstream viewers, but as the Post’s review suggests, even a modicum of anger over the sacrosanct institution of adoption can prompt blinding defensiveness.

I thought of this moment when I read that review, imagining that there was no way someone could sit in the midst of that much collective grief and come away to claim that what happened to these women was charity, or remotely a choice. And I thought about it again when I later watched Philomena myself, in a matinee screening in an outer borough of New York, where two women in their 60s remained in their seats, staring at the credits, long after the theater had emptied.

Philomena, starring Judi Dench and directed by Stephen Frears, received four Oscar nominations last week. The film is based on a true story chronicled in Martin Sixsmith’s 2009 book The Lost Child of Philomena Lee: A Mother, Her Son, and a Fifty-Year Search. Captured is a little known piece of adoption history—the forcible removal of Irish children from their unwed mothers and then adoption by U.S. families. This extraordinary story illustrates the grave injustices of the Magdalene Laundries that were operated under the authority of the Catholic Church. Irish girls and women were forced into slave labor, working long hours cleaning in the laundries. The labor took place in hot, crowded, and generally miserable conditions.

The slavery that took place resulted in a recent legal agreement: The Irish government will now pay €58 million (nearly $79 million) to hundreds of the Magdalene Laundry survivors. Many of the survivors were adolescent girls who were sent to work while pregnant—sent to the Catholic sisters for repentance and remediation. The atrocities were such that Ireland’s prime minister, Enda Kenny, made an emotional apology. “Choking back tears,” he said, “This is a national shame, for which I again say, I am deeply sorry and offer my full and heartfelt apologies.” To date, no such apology or financial settlement has yet to be made by the Catholic Church.

As the film adaptation of Philomena documents, the forced labor in the laundries was deemed necessary to pay for room and board as well as other expenses, such as the medical costs of childbirth. Because the documentation was poor and much of it was intentionally destroyed by the guilty nuns—who set fire to some of the records—various facts have been conveniently lost. As a result, the absolute numbers of children sent into illegal adoptions within and from Ireland to the United States and elsewhere is unknown today. However, the evidence is damning, as Magdalene survivors seek justice and document their histories, including their humiliating living conditions. Part of that evidence is being preserved historically while grave markers document the young women who did not survive the harsh treatment of slavery, poor medical care, and heartbreak of forced child removal and adoptions.

Philomena captures how force and fraud interfaced in illicit adoptions from Ireland to the United States, and this is just the tip of the iceberg. Spain also has a scandal of child sales into adoption, orchestrated by members of the Catholic Church. Some of these Spanish children were also destined to the United States, and search and reunions are taking place in a handful of cases. In the case of Philomena, the main character’s reunion with her lost son has several twists that create suspense. Then there is the sadness of lost love, and it is undeniable.

Philomena is another reminder of the vast inequalities between those who adopt children and birth mothers. Globally, this is a largely untold story in which some birth mothers have been exploited for reasons of poverty, social exclusion, and stigma. This has been true in South Korea, India, Guatemala, El Salvador, and elsewhere, using a variety of child abduction techniques, and the consequences have been profound.

As Philomena illustrates, child abduction takes on many forms, and often those involved in the crime present themselves as “saviors” who are above reproach. Almost always those involved in the illicit practices are financially enriched while receiving applause for the “rescue” of a child. All the while, the birth families are left behind mourning for their loss and, in time, many adoptees as well as birth mothers begin a search. In doing so, they risk intensifying the sense of loss, or they may benefit from ultimately “knowing.”

Even if one has not been personally touched by adoption, the story captures the theme of rebirth of the human spirit, contrasted against the entrapments of daily living in which deeper satisfactions are often overlooked. The film also looks at cynicism versus humor; taking a positive approach to living is most certainly a theme of Philomena. While some may dismiss this as just another feel-good movie, the contrasts and contradictions keep the story real in its intensity.

Audiences are presented with a complicated and true story, told elegantly, while exposing the imperfections of the human experience. Philomena is transnational, adding a dimension of a culture lost, and a birth mother’s yearning to understand the differences while unconditionally accepting the results of her search. Human emotion and the need to reconcile are presented head-on. It is impossible for the audience to leave unaffected. Fundamentally, the act of forgiveness is profound—presenting a clearly developed story line about the challenge of acceptance versus justice that inevitably emerges in the truth and reconciliation of past human rights abuses.

Surprisingly, you will laugh before you cry, and both emotions are well warranted. The networks of social relationships are astonishing, reminding the audience of just how close we may be to someone we have lost and yearn to find. Dench’s character in Philomena is a portrait of how finding happiness and acceptance is very much in how you look at life.

Moviegoers will be left to think more about healing and reproductive injustices of the past, underscoring the mean-spiritedness of some who stand in moral judgment of others. And then there is greed—another dimension of the illicit behaviors and practices of those who have scripted these crimes. Philomena boasts a superb cast supporting Dench.

For more information about the Magdalene Laundries, there are a variety of sources online documenting the lives of women who suffered and survived, as well as those who are deceased; oral histories, photographs, and other artifacts are being collected and appropriate ways in which to honor the women are being considered in terms of museums and other celebrations of their lives and losses. Also, other countries are now investigating their own laundries and survivors, as is the case in Australia. In sum, an astounding social movement for truth and justice is clearly underway, and one way to honor the laundry survivors is hearing their stories. For the act of witnessing is sometimes the only thing that we can do as the story unfolds.

Early Thursday morning, as the Irish Parliament debated making abortion legal in cases when the patient’s life is in danger, one lawmaker demonstrated why many say Irish politics is still not a friendly environment for women. As the debate, which was televised live, entered the pre-dawn hours, a male lawmaker grabbed a female colleague and pulled her onto his lap.

In the video, the incident looks more like a scene from a fraternity party than a historic parliamentary debate about reproductive rights. Member of Parliament Tom Barry grabbed Áine Collins around her waist from behind and pulled her down so she was sitting on his lap. Collins, a member of Parliament from Barry’s own political party, did not appear in the video to be expecting the move, nor did she appear to enjoy it. She got up quickly and walked away.

When first asked about the incident, Barry said it was “horseplay involving two individuals,” but soon after he issued an apology in which he called his actions “disrespectful and inappropriate.”

The Fine Gael Party, which Barry and Collins belong to, also issued a statement. Party secretary, Tom Curran, said, “One deputy’s actions were unwelcome to another deputy. If it happened in any other workplace, it would be unacceptable. That it happened on the floor of Leinster House makes it more so.”

Many in the country said that this incident points to the unequal footing of women in Irish politics. Labour Senator Ivana Bacik tweeted that the vote represented progress for women, but that the incident shows a “deep problem with political culture” and a “need for more women in politics.” A spokesperson for the National Women’s Council of Ireland noted, “Any sexist incident sends a message to women that unprofessional behaviour is acceptable in politics. This discourages women from getting involved.”

At the time of the incident, the lawmakers were considering the “Protection of Life During Pregnancy” bill, which will codify situations in which women can have abortions that are deemed medically necessary. The bill was passed Thursday, with most members of the Fine Gael Party supporting it.

Abortion is outlawed in Ireland under all circumstances, but in 1992 the country’s Supreme Court ruled that abortion should be legal in cases when a doctor agrees that continuing the pregnancy would put the woman’s life in danger. This included cases in which it was deemed likely that the pregnant woman would commit suicide. The six governments that have been in power since this ruling, however, have refused to enforce this rule.

The debate over abortion in the predominantly Catholic country heated up in October of 2012 when Savita Halappanavar died in a Catholic Hospital in Ireland after being denied an abortion that doctors felt could have saved her life.

Last week, members of the Irish parliament, the Dáil, and pro-choice organizations invited me to speak at a meeting in Dublin. The meeting came as parliament was in the midst of debates over a small change to the law, one that would allow women whose lives are at risk as a result of pregnancy to access an abortion without having to travel overseas.

The parliamentarians and activists all seek progressive change in the country’s abortion laws—many wanting much more than is currently on offer. As we talked, I was struck about the similarities that Ireland shared with the country I was born in, the Philippines.

I am proud of my country for many reasons, but mainly for its people. Like the Irish, Filipinos are warm and hospitable people with world-class talents, and many of us work overseas to remit money back to our loved ones.

The parliament stood up for the rights of the people in the Philippines and passed a bill that allows women to, in good faith, make the reproductive health decisions that meet their needs and not those of the hierarchy.

I do not believe that people—especially Catholics—in either the Philippines or Ireland want our elected officials to bend a knee to the will of the bishops.

I’m not suggesting that, in a democratic society, any voice should be silenced, whether or not I agree with it. But it is the job of politicians to carefully examine every lobby group, whether it is a union, a business, or a bishop, before accepting its assertions.

There are a few questions politicians should ask themselves before they accept the bishops’ counsel.

Imposing the hierarchy’s interpretation of the church’s teaching on abortion onto all Irish people would appear to be the antithesis of supporting such an expansive vision of religious freedom.

Individual lawmakers and individual citizens may not agree with the law and may not choose abortion for themselves, regardless of the circumstances they are in. But personal beliefs should not be used to deny the right to others to make those decisions, in good faith and in good conscience.

Irish legislators now face a similar decision to their colleagues in the Philippines: They will either bow to the hierarchy or permit Irish women, Catholic or otherwise, to make their own reproductive health decisions.

As we mark the 50th anniversary of the death of United States’ only Catholic president, John F. Kennedy, we would do well to recall one of his many fine speeches:

I do not speak for my church on public matters, and the church does not speak for me. Whatever issue may come before me as President if I should be elected—on birth control, divorce, censorship, gambling, or any other subject—I will make my decision in accordance with these views, in accordance with what my conscience tells me to be in the national interest, and without regard to outside religious pressure or dictates. And no power or threat of punishment could cause me to decide otherwise.

The conversations I had with the activists in Ireland were honest, forthright, and touching. They want to see real change in their homeland’s anti-abortion laws. I trust that Irish politicians will take their views and President Kennedy’s words into account and do what is right for Irish women, their families, and the nation.

The May 31 announcement regarding the decision to allow Beatriz in El Salvador to have a “premature delivery” requires a continuing response from the abortion rights community.

1. The article states: “The medical team at the Maternity Hospital is ready to act immediately at the slightest sign of danger.” In fact, the opposite is true. Danger signs have existed in Beatriz’s pregnancy from the beginning. Instead of acting on them and terminating the pregnancy as soon as it was known that the embryo had no chance of survival, if not sooner, the medical team of the hospital has put her life at constant risk. Like Savita Halappanavar in Ireland, Beatriz’s condition could suddenly worsen, e.g. her blood pressure could go out of control, her kidneys could fail, and she could die in a short space of time.

No one in the hospital or the Ministry of Health of El Salvador should be allowed to get away with the falsehood that her care is in good hands. Her care is in the hands of people who have been prepared to let her die for the sake of a fetus with no brain, but with only a heartbeat and without the chance of a life.

2. She will be “allowed” to have a caesarean section, described as a “premature delivery.” Why a c-section, why surgery? Is this justified because it is the safest possible form of delivery for her? Can someone explain this please? What is wrong with either a dilatation & evacuation, or induction with mifepristone and misoprostol? Both surely carry fewer risks?

Please recall the case of “Aurora” in Costa Rica, at the end of 2012, who was also carrying a fetus with no chance of life, a fetus whose heartbeat stopped only at 29 weeks of pregnancy. She also was then given a c-section. Some of us asked why that was necessary at the time, but no one raised the question or challenged it publicly. It is time to ask publicly: why is a c-section the delivery method of choice? Is it only because it is the only form of termination of the pregnancy that they think cannot be labelled abortion?

3. Are these two cases representative of a new “Catholic health policy” for pregnant women with an emergency obstetric situation involving a non-viable embryo/fetus – that they are imprisoned in a hospital, in some cases for months, denied a life-preserving abortion until the fetal heartbeat stops, and then delivered of the dead baby by the highest risk procedure possible for the woman, a caesarean section??

Beatriz’s treatment should be considered cruel and degrading treatment and a violation of the Hippocratic oath to do no harm. The protest here is not finished; it is only beginning because cases like Beatriz’s and Aurora’s are only just coming to light through the vigilance and action of human rights and women’s abortion rights groups.

We need to challenge the abortion laws of El Salvador, Costa Rica, Ireland and other countries where even abortion to save the life of the woman is not permitted. But we also must challenge Ministers of Health, parliaments, Supreme Courts, hospitals, and clinicians in every country whose clinical decisions and actions are subservient to the dictates of the Roman Catholic Church’s “health policy” on abortion, which blatantly and cruelly disregards the right to life and health of pregnant women. Whose bottom line is that even with a non-viable embryo/fetus with a heartbeat but no chance of survival a termination is never permissible.

This is a common problem. If health professionals systematically put the lives of their patients at risk for any other ideological non-clinically justifiable reason, it would not be tolerated. I believe any Catholic health professionals and/or hospitals refusing to terminate a pregnancy as emergency obstetric care should be stripped of their right to provide maternity services. In some countries these are the main or only existing maternity services. Even so, governments should refuse to fund these services, and either replace them with non-religious services or require that non-religious staff are available at all times specifically to take charge of such cases to prevent unnecessary deaths. At issue is whether a woman’s life comes first or not at all.

]]>http://rhrealitycheck.org/article/2013/06/01/its-time-to-strip-catholic-hospitals-of-their-right-to-provide-maternity-care/feed/179Ireland’s Protection of Life During Pregnancy Bill: 21 Years After X, Business as Usual?http://rhrealitycheck.org/article/2013/05/08/irelands-protection-of-life-during-pregnancy-bill-21-years-after-x-business-as-usual/?utm_source=rss&utm_medium=rss&utm_campaign=irelands-protection-of-life-during-pregnancy-bill-21-years-after-x-business-as-usual
http://rhrealitycheck.org/article/2013/05/08/irelands-protection-of-life-during-pregnancy-bill-21-years-after-x-business-as-usual/#commentsWed, 08 May 2013 12:40:54 +0000http://rhrealitycheck.org/?p=19042

In the wake of the tragic and preventable death of Savita Halappanavar, Irish politicians promised that this government would "not become the seventh to 'neglect and ignore' the issue of the Supreme Court ruling abortion on the X Case." Six months later, the cabinet hasproposed a bill it says will not "change the law" on abortion.

Six months later, the cabinet has proposed a bill it says will not “change the law” on abortion. That is certainly clear. The bill does not change anything for the women who make the heartbreaking trip across the Irish Sea to Liverpool to end much wanted pregnancies following a diagnosis of catastrophic fetal anomaly. The bill does not address the thousands that fly into London, Liverpool, and Manchester to access abortion when they simply cannot contemplate having a baby (or another baby) at this time. The bill does not offer any comfort to those who are pregnant due to rape or abuse. The bill will not change the law. The question is will the bill provide the clarity that women and doctors so desperately need to prevent another tragic and unnecessary death?

Did anyone notice how seamlessly the name of this bill was changed from the “protection of maternal life” to the “protection of life during pregnancy”? Significant? The bill states more than once that its intention is not to ask doctors to weigh the life of the fetus against the life of the woman. However, when it demands that a doctor provides a reasonable opinion, its definition of “reasonable opinion” is “an opinion formed in good faith which has regard to the need to preserve unborn human life as far as practicable.” So fetal life remains a consideration.

Similarly the bill quotes the 1992 Supreme Court judgment on the X case, that “it is not necessary for medical practitioners to be of the opinion that the risk to the woman’s life is inevitable or immediate, as this approach insufficiently vindicates the pregnant woman’s right to life.” At the same time it emphasizes that there must be a “real and substantial risk to the woman’s life.” This is typical of the confusing, equivocal, and obfuscating tone of the whole bill. We want to save women’s lives, but…

The regulations state two grounds for allowing an abortion: the serious risk of death for the woman from “physical illness” and the risk of death from “self-destruction” (suicide). In the meantime the bill offers no clarity about where on the trajectory between diagnosis of a pregnancy complication or expression of suicidal ideation, and death a doctor can legitimately provide abortion? This is exactly the conundrum that faced the doctors in the Halappanavar case.

When clinicians in the United Kingdom (excluding Northern Ireland) tell you that they would rather err on the side of caution, it means proceeding with abortion before a woman is at death’s door. In legally restricted jurisdictions such as Ireland, the side of caution means ensuring you and your patient are not risking 14 years in prison by acting too soon. It is not clear that the process set out in the bill will solve this problem because it is notoriously difficult to assess or even get agreement from colleagues about the level of risk a woman faces until often it’s too late.

As Obstetrician/Gynecologist Christian Fiala explains, “All laws which allow abortion only to ‘save the life of the woman’ are inherently unworkable. For a simple reason: you only know after the woman died that her life really was in danger. It is impossible to exactly predict when a patient will die. And as long as she is still alive there is always someone in the medical team who will raise his voice and ask to wait for another day and another day … until it is too late. The same applies to the current initiatives to verify whether or not a woman is really suicidal. This is impossible to reliably predict beforehand. If you really want to know, you have to see and wait … until it is too late.”

Given that the bill calls for two doctors to make the decision in the case of “physical illness” (except in an emergency situation) and three in the case of “self-destruction” there is generous scope for disagreement and procrastination.

So what does the bill improve? For those doctors who felt too vulnerable to act, even to save a woman’s life, regulation may be welcome. It provides a clear process for them, if an uncertain outcome for the woman. The process may rule out the possibility of abortion, but the doctor will have done the “right thing” by trying. The process is convoluted and possibly unworkable, especially in the case of suicidal ideation, but for the first time at least it’s in writing—it’s official.

It may appease Ireland’s friends and neighbors who looked on appalled as the Halappanavar case played out; and, in a dim light, it appears to meet the demand for legislation on this issue. As RHM Editor Marge Berer says, “It is a gift to the politicians who must have felt (no matter what their personal views) that their political lives were not worth having this fight. They can now say, ‘We did exactly what we were told to do by the European Court’ and no more. It will be impossible to oppose it—in those terms—from any point of view. The person/people who drafted it deserve a gold star for compliance with the political necessity involved.”

However, for those doctors who previously relied on their clinical judgment and did provide life-saving abortions, they may now find themselves tied up in red tape and delays, jumping through hoops that weren’t there yesterday. The powerful need to deny the very notion of life-saving abortion has meant that, to date, abortion has sometimes taken place, but quietly without fuss or comment, without anyone even naming it let alone publishing statistics on prevalence. According to one commentator, “The bizarre official position is: abortions happen in Ireland, but we don’t count them.” The nation, it seems, turned a blind eye. Now there are no blind eyes. All eyes are on the doctors.

Moreover, the details of the bill give a very clear message. The need for a specific combination of different clinicians who must practice in specific institutions, who will need to be certified and registered as suitable by professional associations to follow professional guidance that is yet to be written, and who will all need to be available in the right place at the right time, and if they can’t agree it will have to go to appeal, which could take up to seven days, and it is not entirely clear whether that appeal process might also be open to those hoping to block the abortion, and all this must happen in what may be a short window of opportunity to save a woman’s life—the message is that it may be easier to travel, or to die. So, business as usual then.

Last year, RH Reality Check reported on the tragic and wholly preventable death of Savita Halappanavar at Galway University Hospital. Halappanavar, a dentist who was pregnant with her first child, was admitted to the hospital with severe back pain. She was in the midst of miscarrying a non-viable fetus in a much-wanted pregnancy.

Over the course of three days, Halappanavar experienced an incomplete miscarriage that resulted in a life-threatening infection and unbearable pain. Halappanavar and her husband begged doctors to terminate the pregnancy. The doctors refused because, as she was told by the hospital’s midwife manager, Anna Maria Burke, “Ireland is a Catholic country.”

And in that Catholic country, where a woman’s life is secondary to a non-viable fetus, the woman died.

Now, a report by the Health Service Executive has concluded, according to the Irish Times, that there was “an overemphasis by hospital staff on the welfare of Ms Halappanavar’s unviable foetus and an underemphasis on her deteriorating health.”

As reported by the Times, the report says, “The investigating team considers there was an apparent overemphasis on the need not to intervene until the foetal heart stopped, together with an underemphasis on the need to focus an appropriate attention on monitoring for and managing the risk of infection and sepsis in the mother.”

The final draft of the report did not mention the widely quoted comment by Burke about Ireland being a “Catholic country” where doctors would not end a miscarriage, but Burke admitted to saying this during testimony.

Reading reports of testimony provided during the inquest left me feeling the panicked helplessness I can only imagine that Praveen Halappanavar felt as his wife lay dying from a preventable and treatable condition that was treated as subordinate to a pregnancy that could not succeed. Reading the details of their ordeal is difficult even for a complete outsider.

According to both the timeline of Halappanavar’s “care” and reports by clinicians who evaluated the records, it is clear that infection had already set in when Savita was admitted to the hospital, but tests revealing elevated white blood counts were “not immediately relayed” to her doctors.

According to experts interviewed by the Times, the key issues arising from the report revealed that “on admission to the Galway University Hospital on Sunday, October 21st, Ms Halappanavar’s white blood-cell count was elevated, which indicated her body was fighting an infection.”

It finds her vital signs were inadequately monitored; that she was seriously ill by the evening of Tuesday 23rd, but that this was not acted on; that her team saw her on the morning of Wednesday 24th and she had further deteriorated, and still this was not acted on adequately; that further blood samples were not taken until later that day and that the High Dependency Unit did not get involved until the Wednesday evening, after the foetal heartbeat had stopped.

In a subsequent article, the Times reports that Dr. Susan Knowles, a consultant microbiologist at the National Maternity Hospital who testified at the inquest, “was also critical of poor documentation at a critical time in Ms Halappanavar’s care on Wednesday, October 24th last.”

Moreover, the report notes that “the possibility of performing an abortion was discussed by the medical team on the Wednesday. Mr Halappanavar was unaware this had been discussed. The couple’s request for a termination on the Tuesday is acknowledged in the report, but not in Ms Halappanavar’s medical notes.”

So doctors and nurses knew they had a non-viable fetus, they knew they had a woman at high risk of death, and they must have known that time was of the essence.